3. High-intensity interval training and lipid profile in overweight women 149
followed by 12 seconds of recovery compared to steady-
state exercise intensity resulted in considerable changes in
total body fat, foot, truck and subcutaneous fat in young
inactive female participants [17]. This finding is, despite the
lack of increase in lean body, observed in persistence partic-
ipation in aerobic exercise [18]. In another study conducted
by Heydari et al., the effect of 12 weeks of HIIT program with
12 to 8 intervals of exercise/recovery was examined in young
men and reported similar results in regard to the significant
change in fat percentage and anthropometric indices [19].
HIIT in a similar workload and comparatively estimated
energy expenditure is a suitable replacement for aero-
bic program. The mechanism of such training program
includes one stage of high-intensity activity that requires
ATP replacement from each of the energy sets. For instance,
Billaut and Bishop reported that the proportion of energy
production needed in a 30 second high-intensity activity
includes 18 percent ATP, 2% phosphagen, 25% anaerobic gly-
colysis, and 55% oxidation [20]. There are evidences that
show if the recovery time to the resting state in high inten-
sity is reduced, the glycolysis activity for rebuilding the
energy also decreases and, as result, aerobic metabolism
for energy replacement increases. Linossier et al. (1993)
claimed that aerobic metabolism during the recovery period
after a high-intensity activity for replacing phosphocrea-
tine and lactic acid oxidation play an important role. As
a result of such condition, performing HIIT programs with
short recovery time result in increasing aerobic metabolism
[21].
Considering the lack of research related to the different
recovery periods from the high-intensity interval training
program on the liver enzymes of overweight low active
female subjects, this study was designed to examine if there
is any significant effect of participation in 4 weeks of HIIT
program on changes of liver enzymes and body composition
of overweight low active female subjects.
2. Methodology
In this quasi-experimental research, 24 overweight to obese
low active volunteer women with the mean age of
34.42 ± 5.3 years old participated. The demographic infor-
mation of the participants is presented in Table 1. The
participants’ activity habit was assessed by response of the
respondents to a questionnaire. For the purpose of measur-
ing physical activity level, RPAQ was employed. Researchers
employ individuals who claim they had 2 to 3 sessions of
physical activity such as gardening, bicycling or walking,
jogging, yoga or volleyball per month. The entire research
protocol was approved by Research Ethic Committee of
the Human Sciences College of Tarbiat Modares Univer-
sity. In addition, health history questionnaire was employed
to collect information in regard to medical history, drug
consumption, consuming food supplements including amino
acids, creatine, or vitamin that could influence the outcome
of the study during the last 6 months of study and any kind
of activity during the last 2 months that may interfere with
the results. The BMI of the participants in this study ranged
from 25 to 30 and aged from 30 to 42 years. In addition, the
exercise program was conducted in a bodybuilding club. All
the participants were followed and supervised during the
study period. The subjects refrained from vigorous exer-
cise 24 hours before testing and were tested after a 10-hour
fast. To reduce the influence of previous food consump-
tion on the substrate response during exercise, the subjects
were instructed to maintain their normal diet throughout
the study.
Potential subjects were excluded from the study if they
had 2 or more risk factors on the health history question-
naire, were using any medications that could affect exercise
or metabolism, were a current smoker, or consumed a veg-
etarian diet.
2.1. Exercise protocol
The exercise protocol for this research was performed by
treadmill. The speed of treadmill was determined based on
several pilot trials prior to the start of main training proto-
col according to the reserve heart rate by using the Karnin
method. The treadmill was Polar Electro Inc, Lake Success,
NY brand. Before every training session, reserved heart rate
was calculated and the activity intensity was determined
accordingly. Twelve sessions of intensive speedy interval
training was performed for 4 weeks. The participants were
randomly assigned into two groups of training and one group
of control (n = 8, one group of 10 trails interspaced with one
minute of rest and 10 trials interspaced by 30 second rest).
The training sessions started with 3 minutes of warm up and
80 percent of reserved heart rate followed by 2 minutes of
cool down. In the first week, there were 4 trials and weekly
it was increased by 2 bouts ending by 10 bouts. Maximum
heart rate was determined based on the 220-age equation.
2.2. Body composition
The height and weight of the participants was measure by
stadiometer (with sensitivity of 1 mm) and digital scale,
respectively. The waist and hip was measured by flexible
tape placed around the waist at the umbilical cord and hip at
the largest circumference in standing position. The body fat
percent was measured by 7-point skinfold caliper [22,23].
These measures were performed twice, once before and
again at the end of the 4-week training protocol.
2.3. Blood variables
For the purpose of blood analysis, 5 cc of left arm venous
blood was drawn at 8 AM two days prior and after the termi-
nation of the exercise protocol. By employing a questioner,
regular menstruation period of 28 to 32 days was ensured and
accordingly all the blood samples were collected during the
follicle stage of menstruation period. All the collected sam-
ples were kept frozen at —80 ◦
C. Blood components including
HDL-C were measured by CV 0.73, Triglyceride 1.82, and
cholesterol with CV 0.61. The kits were prepared by Pars
Azmon Co. of Iran.
2.4. Statistical analysis
All statistical analyses were carried out using SPSS ver-
sion 16.0. The normality of data was confirmed by
4. 150 S.J. Mirghani, M.S. Yousefi
Table 1 Demographic characteristics of the participants.
Groups Variables
n Age (year) Height (cm) Weight (kg) BMI (kg/m2
)
Experimental Group (60/60) 8 0.33 ± 5.377 15.158 ± 60.3 83.54 ± 12.15 32.18 ± 3.80
Experimental Group (60/30) 8 0.32 ± 5.394 14.159 ± 50.4 70.84 ± 5.16 28.11 ± 3.34
Control group 8 0.35 ± 5.311 13.160 ± 45.3 70.11 ± 2.61 28.15 ± 1.16
BMI: Body Mass Index.
Kolmogorov-Smirinov test. The difference between the
pretest-post-test of all the measured variables was used to
test the hypothesis. One-way analysis of variance (ANOVA)
was employed to compare the results and Tukey post-hoc
test was used to compare the means if a significant differ-
ence was found. The association of liver enzymes with lipid
profile was tested by Pearson correlation coefficient. All the
hypotheses were examined at alpha level set to 0.05. Also,
df for the ANOVA in all variables was 2.18.
3. Results
3.1. Liver enzymes
The level of changes in AST, ALT and ALP for the rest
ratio of 60/60, 60/30 and control groups in pretest and
post-test state are presented in Figs. 1—3. The result of
analysis showed that there was no significant changes in AST
(F(2,18) = 1.97, P = 0.168); ALT (F(2,18) = 1.97, P = 0.168); ALP
(F(2,18) = 0.256, P = 0.777) among the three groups.
3.2. Blood lipids
The result of analysis showed that there were no significant
differences between the HDL-C (P = 0.644) among the exper-
imental groups. In addition, there were also no significant
differences in the cholesterol and triglyceride level of the
experimental groups (P = 0.599, 541) after the completion of
the exercise protocol (Table 2).
The correlation coefficients between the ALT and serum
cholesterol was not significant (r = 0.31, P = 0.46) nor the
correlation between the ALT and TG or ALT and LDL-C
were significant (r = 0.16, P = 0.48; r = 0.08, P = 0.705). In
addition, the correlation between the AST and serum choles-
terol, TG and LDL-C were not significant (r = 0.20, P = 0.382;
r = 0.11, P = 0.630, r = 0.15, P = 0.491). Finally, the correla-
tion between the ALP and serum cholesterol, TG and LDL-C
were not significant (r = 0.19, P = 0.387; r = 0.08, P = 0.73,
r = 16, P = 0.483).
However, a negative significant correlation between the
ALT and HDL-C and AST and HDL-C was found (r = —0.57,
P < 0.01; r = 0.49, P < 0.05) whereas the correlation between
the ALP and HDL-C was not significant (r = 0.18, P = 0.423).
3.3. Anthropometric indices
The result of analysis indicated that there was a significant
changes in the level of fat mass of the experimental groups
(P < 0.05) following the completion of the exercise protocol.
Tukey post-hoc test indicated that there were no signifi-
cant differences between the 60/60 and 60/30 activity-rest
interval (P = 0.511) nor between the 60/60 ratio and the
control group (P = 0.143) whereas there was a significant dif-
ferences between the 60/30 activity-rest interval and the
control group (P < 0.05). The exercise program in this group
significantly decreased the body fat mass. In addition, no
significant changes in waist to hip ratio (P = 0.134), weight
(P = 0.238), BMI (P = 0.564), systolic (P = 0.517) and diastole
(P = 0.502) blood pressure was observed in the experimental
groups (see Table 3).
4. Discussion
The effect of 4 weeks of high-intensity interval training on
some of the liver enzymes and serum blood lipids of low
active over weight females was examined in this research.
The results indicated that there were no significant changes
in ALT, AST and ALP of the 60/60, 60/30 activity-rest inter-
vals and control group following the completion of the
exercise protocol. The result of studies conducted by Rector
and associate [24], Ghorbani et al. [12], Thomas and Song
[25] and Kinoshitoo et al. [26] also indicated that there was
no significant change in these enzymes following the par-
ticipation in exercise program. Cunha et al. [27] examined
the effect of six weeks of swimming 5 days per week on
transaminase of plasma and concluded that such program
did not result in significant changes in this factor. These
results are in agreement with the results observed in the
present research. However, the result of research reported
by Mir and colleagues showed that participation in 8 weeks of
aerobic exercise decreased the level of ALT and AST enzymes
[7]. This is in contrary to the study of Smith et al. [28] that
claim these changes may reveal the duration of exercise.
One of the consequences of participation in exercise pro-
grams is acute liver damage that is associated with increase
in liver enzymes [29]. Pettersson et al. [6] examined the
effect of intensive physical training (weight-lifting) on liver
functions of healthy men and concluded that the level of ALT
and AST was significantly increased whereas the level of ALP
did not change significantly. Ghorbani et al. [12] reported no
significant changes in ALT following one intensive HIIT simi-
lar to the result of the present research while they found a
significant change in AST and ALP following the exercise pro-
gram. In addition, Thomas and Song stated that performing
exhaustive exercise on treadmill at the speed of 10.30 km/h
by men and 6.52 km/h by women had no effect on the level
of AST [25]. Kinoshitoo et al. also showed that participation
5. High-intensity interval training and lipid profile in overweight women 151
Figure 1 Comparing the pre- and post-level of AST (e.g., aspartate aminotransferase) or SGOT(e.g., serum glutamic-oxaloacetic
transaminase) in the 60/60 to 60/30 activity-rest interval groups.
in exercise programs of different intensity did not result in
significant change in liver enzymes [26].
Some of the research reports show significant association
between the liver enzymes and anthropometric variables
[3]. The result of the present research indicated that there
was a significant negative association between ALT and
HDFL-C and between AST and HDL-C. Other research results
have shown a significant association between BMI, body
weight and visceral fat with liver enzymes [27,28]. How-
ever, no significant relationships between the other body
fat indices and liver have been reported. Nah et al. reported
that there was no significant association between HDL-C and
TG with liver enzymes whereas they found a significant rela-
tionship between HDL-C and liver enzymes [29]. On the other
hand, Wisniewska et al. reported that there was a signifi-
cant positive relationship between HDL-C and TG with some
of the liver enzymes including ALT and negative significant
association with HDL-C in subjects who were suffering from
non-alcoholic fat liver syndrome (NAFLD) [30]; this finding
that is similar to the findings of the present research. Consid-
ering these contradictory findings, it seems necessary to
conduct more studies in regard to the relationship between
the serum lipids and liver enzymes.
In addition, among the changes related to obesity in
the present research, no significant difference in the level
of blood lipids, weight, and indices of measuring fat level
in overweight women was not found. These findings are
in agreement with the findings of Olson et al. [31], Zois
Figure 2 Comparing the pre- and post-level of ALT (e.g., alanine aminotransferase) or SGPT (e.g., serum glutamic pyruvic
transaminase) in the 60/60 to 60/30 activity-rest interval groups.
6. 152 S.J. Mirghani, M.S. Yousefi
Figure 3 Comparing the pre- and post-level of ALP (e.g., alkaline phosphatase) in the 60/60 to 60/30 activity-rest interval groups.
et al. [32], Manning et al. [33], Johnson et al. [34] and
Boudou et al. [35]. More research conducted by King et al.
[36] showed that 8 weeks of walking had no significant
effect on body fat mass of fat women. These authors con-
cluded that no significant change occurred in blood lipids,
body composition of obese women following the partic-
ipation in exercise training. Contrary to the findings of
the present research are the findings of Trapp et al. [17]
who examined the effect of 15 weeks of HIIT program on
inactive young women. They reported that participation
in HIIT did result in significant decrease in body mass, fat
mass, trunk fat and lipid concentration of blood in inactive
young women. The possible explanation for such contra-
dictory finding may be attributed to the different duration
of the training programs. It need to be mentioned that in
the present research significant decrease in body fat per-
cent occurred in 60-30 second training group compared to
the control group. The results of studies show that the
recovery period following the termination of high-intensity
exercise program influences the substrate change and the
contribution of fat oxidation in metabolism highly increases
[37,38]. Heydari et al. [19] showed that 12 weeks of HIIT
program including high-intensity bout of running interspaced
by 8 second of rest interval followed by 12 second of recov-
ery in young men led to significant decrease in total body
fat, abdomen and trunk fat, visceral fat and body weight
in one hand and increase in lead body mass in other hand.
These findings pinpoint to the significance of recovery in
post exercise metabolism. Thus, researchers believe that
aerobic metabolism during the recovery period from High-
intensity exercise for replenishment of phosphocreatine and
lactic acid oxidation play significant role [21].
It is important to mention that the participants in this
research during one month were involved in 3 to 4 sessions
of recreational activity. This in turn may be one of the causes
that no significant changes in liver indices and blood fat level
were observed.
Manning et al. claimed that the initial level of blood lipid
level might have some influence on the level of changes of
these substrates due to the participation in exercise pro-
gram [33]. Therefore, the starting level of HDL-C and LDL-C
[33] in addition to the normal level of weight (non-obese)
Table 2 Lipid profile of 60/60 to 60/30 activity-rest interval and control groups.
Variables Group Pretest Post-test Pre-post-test differences F Sig.
HDL-C (g/dL) 60.60 46.28 ± 11.04 46.28 ± 7.9 0.00 ± 6.3 0.201 0.82
60.30 46.00 ± 11.04 47.57 ± 8.10 1.57 ± 19.4
Control 44.28 ± 3.8 44.00 ± 8.5 —0.28 ± 8.5
HDL/LDL 60.60 0.424 ± 0.11 0.450 ± 0.11 0.026 ± 0.03 0.45 0.644
60.30 0.483 ± 0.15 0.525 ± 0.16 0.042 ± 0.07
Control 0.495 ± 0.19 0.506 ± 0.17 0.010 ± 0.06
Cholesterol (g/dL) 60.60 17.7 ± 18.2 173.0 ± 14.8 —4.71 ± 11.1 0.52 0.599
60.30 167.2 ± 33.5 169.7 ± 36.2 2.57 ± 18.6
Control 162.2 ± 22.6 167.5 ± 43.2 5.28 ± 14.4
Triglyceride (g/dL) 60.60 103.4 ± 50.5 113.2 ± 47.3 9.85 ± 17.66 0.63 0.541
60.30 106 ± 46.6 137.1 ± 92.08 31.1 ± 56.8
Control 109 ± 7.47 146.7 ± 90.03 37.7 ± 58.9
Significant difference from baseline values (p, 0.05)
7. High-intensity interval training and lipid profile in overweight women 153
Table 3 Anthropometric indices of 60/60 to 60/30 activity-rest interval and control groups.
Variables Group Pretest Post-test Pre-post-test differences F Sig.
Fat mass 60.60 40.90 ± 0.81 40.44 ± 0.91 —0.455 ± 0.43 4.98 a
0.019
60.30 41.82 ± 0.73 41.17 ± 0.17 —0.65 ± 0.32
Control 41.17 ± 1.14 41.06 ± 1.10 —0.102 ± 0.19
Waist/hip ratio 60.60 0.872 ± 0.10 0.877 ± 1.10 —1.15 ± 0.87 2.25 0.143
60.30 0.897 ± 0.05 0.811 ± 0.06 —0.0628 ± 0.41
Control 0.818 ± 0.06 0.814 ± 0.07 —0.457 ± 0.92
Weight (kg) 60.60 83.54 ± 12.15 82.38 ± 12.13 —1.15 ± 0.87 1.55 0.238
60.30 70.84 ± 5.16 70.21 ± 5.08 —0.628 ± 0.41
Control 70.11 ± 2.61 69.65 ± 2.07 —0.457 ± 0.92
Systolic blood
pressure (mmHg)
60.60 12.11 ± 0.65 12.14 ± 0.37 0.028 ± 0.52
60.30 11.57 ± 0.60 11.57 ± 0.78 0.00 ± 0.86
Control 12.07 ± 0.18 11.71 ± 0.48 —0.357 ± 0.62 0.658 0.517
Diastolic blood
pressure (mmHg)
60.60 8.35 ± 0.62 8.28 ± 0.75 —0.07 ± 0.44 0.716 0.502
60.30 8.14 ± 0.24 8.00 ± 0.57 —0.142 ± 0.74
Control 8.57 ± 078 8.14 ± 0.37 —0.428 ± 0.53
BMI (body mass index,
weight/height2)
60.60 32.18 ± 3.80 31.74 ± 3.44 —0.442 ± 0.75 0.590 0.564
60.30 28.11 ± 3.34 27.70 ± 3.57 —0.407 ± 0.50
Control 28.15 ± 1.16 28.02 ± 1.05 —0.133 ± 0.44
a Significant difference from baseline values (p, 0.05).
of the participants [39] may have determining effect on the
changes of these factors. In addition, the types of sports
depending on the gender but not the fitness level of the
person may also contribute to the level of changes in these
parameters [30]. Careful examination of research reports
reveal that many factors including the time of blood samp-
ling and laboratory methods may also contribute to the
contradictory findings in this regard [31]. In addition, there
are even reports that show the role of individual differences
[40] and sex [28] in regard to the fat level changes that may
also be the reasons for contradictory findings of the present
research.
5. Conclusion
The result of the present research showed that 4 weeks of
HIIT program did not result in significant change in the level
of liver enzymes, blood lipid profiles, and fat indices in over-
weight lightly active women. However, the result showed
that 60 to 30 activity-rest interval was more effective than
the 60 to 60 activity-rest interval for compensating energy
through energy shift from glycolysis toward aerobic pathway
has been effective in reducing fat percent. In addition to the
factors such as primary stage of physical fitness, not being
fat, starting level of blood lipids, the duration of training
is an important factor in lack of significant adjustment in
variables. In other hand, it was found that there is a sig-
nificant correlation between some of the liver enzymes and
HDL-C. It was concluded that more research is needed to
control factors such as sex, age, type of activity and exercise
protocols.
Disclosure of interest
The authors declare that they have no conflicts of interest
concerning this article.
Acknowledgement
The researcher wishes to express their appreciation to sin-
cere contribution of Nosrati, the trainer and coach of the
participants. In addition, many thanks to Dr. Hossein Nasehi,
the Sepid lab director, for the lab analysis.
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![148 S.J. Mirghani, M.S. Yousefi
Conclusion. — Based on the result of this research, 4 weeks of HIIT activities result in no signifi-
cant change in indices of blood lipids as well as liver enzymes. However, a considerable change
was observed in the body fat percent that may be attributed to the exercise protocol.
© 2014 Published by Elsevier Masson SAS.
MOTS CLÉS
Enzymes hépatiques ;
Entraînement
fractionné à haute
intensité ;
Bilan lipidique ;
Femmes en surpoids
Résumé
Introduction. — L’entraînement fractionné de haute intensité (HIIT) est considéré comme un
moyen efficace d’amélioration des paramètres lipidiques du sang. On sait que certaines des
enzymes du foie sont prises en compte comme indices les plus importants pour apprécier le
fonctionnement d’un foie sain. Donc, l’objectif de cette recherche est d’étudier l’influence de
différentes phases de récupération pendant l’entraînement fractionné à haute intensité sur les
enzymes du foie et le profil lipidique sanguin chez les femmes en surpoids.
Méthodologie. — Vingt-quatre femmes (âge : 34,42 + 5,3 ans, IMC : 29,48 + 3,45, poids : 80 + 0,08,
taille : 159,14 + 4,60), volontaires, ont été tirées au sort et divisées en trois groupes de
8 personnes). Le protocole d’exercice comprenait quatre semaines de quatre séances, dont
trois par semaine à 80 % de la FC maximale pour atteindre 10 essais la quatrième semaine.
Résultats. — Quatre semaines d’entraînement fractionné à haute intensité n’a pas montré un
changement significatif du profil lipidique sanguin (HDL-C, HDL/LDL, cholestérol et trigly-
cérides) ainsi que pour les enzymes hépatiques ainsi que pour la composition corporelle (p < 5 %).
Mais il y avait une différence significative dans le pourcentage de graisses pour ces trois groupes
(p < 5 %) et, en plus, une relation inverse entre les enzymes hépatiques et le HDL-C (p < 5 %).
Conclusion. — Cette étude montre qu’un programme d’HIIT ne modifie pas le profil lipidique
sanguin ainsi que le taux d’enzymes hépatiques. Cependant on observe un changement du
pourcentage de graisses corporelles qui peut résulter du protocole d’exercice.
© 2014 Publi´e par Elsevier Masson SAS.
1. Introduction
Overweightness and obesity are two of the known risk fac-
tors of health and wellness that are very common in the
present time in all societies [1]. It has been claimed that the
amount of some of the enzymes are indicative of the nor-
mal functioning of liver [2]. For instance, the normal level
of alanine aminotransferase (ALT) or aspartate aminotrans-
ferase (AST) are indications of normal functioning of liver
cells and normal level of alkaline phosphatase (ALP) shows
that there is sufficient level of albumin for the production
of protein [2,3]. The result of some researches show that
the amount of some of the proteins measured through Liver
Function Test (LFT) is dependent on some factors including
body mass index [4], age [3] and environmental factors [2].
Thus, participating in physical activities is one of the strate-
gies to decrease the risk factors of liver diseases such as fat
liver syndrome and diabetes [5].
The results of studies show that the change in level of
activities of different enzymes varies depending on inten-
sity, duration and types of physical activities. Banfi et al.
examined the effect of 10 to 15 weeks of aerobic versus 5 to
10 weeks of anaerobic exercise on changes of AST and ALT
of horse muscles and reported that the level of activities of
enzymes increased nearly twice. They also reported that the
level of these enzymes decreased significantly after 5 weeks
of detraining. However, 10 weeks later, they observed an
increase in the level of enzymes with no known reason [4].
Pettersson et al. conducted a research to examine the effect
of resistance training on the chemical factors reflecting the
functioning of liver in 15 healthy young men. They reported
that the level of ALT and AST increased considerable fol-
lowing the completion of physical activities but the level of
ALP remained at the normal level and did not change sig-
nificantly [6]. Mir et al. also demonstrated that 8 weeks of
aerobic exercise in individuals suffering from fat liver syn-
drome resulted in significant changes in liver enzymes. They
concluded that aerobic exercise led to significant decrease
in AST and ALT [7].
The result of some studies have indicated that aerobic
exercise, despite being relatively long, result in minimal
change in lipid profiles [8], whereas participation in inten-
sive interval training result in higher level of decrease in
lipid profiles [9]. In addition, there is reliable evidence that
show lack of time is an obstacle for participation in aero-
bic exercise [10], therefore, short time interval training are
more attractive and efficient for engagement of people in
exerciser [11]. Ghorbani et al. examined the effect of par-
ticipation in short period of interval training in adult soccer
players on their liver enzymes including ALP And AST and did
not find any significant change in the level of these enzymes
while they reported that ALT did change considerable [12].
Different researches have indicated that more reduc-
tion in body fat mass has occurred by using low-intensity
training programs [13,14]. Other researchers have shown
that more reduction in fat indices may occur due to par-
ticipation in prolonged training compared to HIIT program
[15]. Shelley et al. also performed continued training pro-
grams on sedentary 18—55 years old adults and showed that
more reduction in body fat occurred compared to the HIIT
program [16]. However, Trapp et al. showed that 15 weeks
of HIIT program interspaced by 8 seconds of rest interval](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)